Stuttering Notes

Key Concepts and Terms - Chapter 8

1. What is Stuttering?

• Stuttering is a fluency disorder characterized by disruptions in speech.
• These disruptions include repetitions, prolongations, and blocks.
• Stuttering can be inherited; genetics play a role, especially in developmental stuttering.
• A family history of stuttering increases the risk of developing the disorder.

2. Stuttering Prevalence: Males vs. Females

• Stuttering occurs more often in males than in females.
• The male-to-female ratio is approximately 4:1 in persistent cases.
• In early childhood, the ratio may be closer to 2:1 but increases with age.

3. Characteristics of Stuttering

Primary (Core) Characteristics:

• Part-word repetitions (e.g., "b-b-b-ball")
• Whole-word repetitions (e.g., "I-I-I want that")
• Prolongations (e.g., "ssssssoup")
• Blocks (no sound comes out despite effort)

Secondary Characteristics (Learned Behaviors):

• Facial tension or grimacing
• Eye blinking
• Head movements or foot tapping
• Avoiding certain words or speaking situations
• Using filler words (“um,” “like”) to delay speech

4. Stuttering Assessment: Calculating Stuttering Percentage

A. Syllable-based Percentage

1. Count the total number of syllables spoken.
2. Count the number of stuttered syllables.
3. Formula: Stuttering Percentage = (\frac{Stuttered syllables}{Total syllables}) \times 100

B. Word-based Percentage

• Same formula as syllable-based, but using words instead of syllables.
• Less accurate for young children; syllable-based is preferred in most assessments.

5. Intervention Techniques for Children

Techniques:

• Indirect therapy (especially for preschoolers):
  • Adjust the environment to be more conducive to fluency.
  • Slow adult speech to provide a model for the child.
  • Reduce pressure on the child during speaking situations.
• Direct therapy (for older children):
  • Easy onset: Initiating speech in a gentle, relaxed manner.
  • Stretchy speech: Prolonging sounds slightly to maintain fluency.
  • Light articulatory contacts: Using minimal tension when producing sounds.
  • Pausing and phrasing: Incorporating strategic pauses and natural phrasing.
  • Stuttering modification (e.g., cancellations, pull-outs): Techniques to manage and modify moments of stuttering.
  • Fluency shaping: Techniques to promote overall fluent speech production.

Family Involvement:

• Educate parents about reducing pressure during speaking.
• Encourage positive speaking interactions.
• Involve them in home practice activities.
• Monitor progress with parental feedback.

6. Differentiating Normal Disfluency from Stuttering

• Counting the total number of disfluencies alone is least helpful.
• What matters more is the type of disfluency (e.g., part-word repetitions, blocks) and the child’s reaction (tension, awareness, frustration).
• Also consider duration and consistency.

7. Stuttering vs. Cluttering